Pregnancy outcomes following hospitalisation for a fall in Washington State from 1987 to 2004.
OBJECTIVE
To evaluate the risk of adverse maternal and perinatal outcomes among pregnant women hospitalised following falls.


METHODS
A population-based retrospective cohort study.


METHODS
Washington State, USA.


METHODS
Pregnant women with a fetal death or live birth certificate linked to the hospitalisation discharge data from 1987 to 2004.


METHODS
Pregnant women who experienced a fall (n = 693) were identified by the presence of an International Classification of Disease-9th Edition external causation code of E880 through E888 and were compared with a randomly chosen group of pregnant women (n = 2079) not experiencing a fall hospitalisation during pregnancy. Poisson regression analysis was used to estimate adjusted relative risks (RR) and 95% CI for associations between falls and pregnancy outcomes.


METHODS
Preterm labour and delivery, placental abruption, fetal distress, and fetal hypoxia.


RESULTS
This study found an incidence rate of 48.9 pregnant fall hospitalisations per 100 000 deliveries. The majority of the fall hospitalisations occurred in the third trimester (79.3%), with 11.3% in the second trimester and 9.4% in the first trimester. The majority of injuries due to falls were fractures (47.4%), especially of the lower extremity, followed by contusions (18.0%) and sprains (17.3%). Falls were associated with an increased risk of preterm labour (RR 4.4, 95% CI 3.4-5.7), placental abruption (RR 8.0, 95% CI 4.3-15.0), fetal distress (RR 2.1, 95% CI 1.6-2.8), and fetal hypoxia (RR 2.9, 95% CI 1.3-6.5).


CONCLUSIONS
In light of the increased risk of adverse maternal and perinatal outcomes associated with major falls resulting in hospitalisation, careful maternal and fetal monitoring following a major fall is warranted.
Schiff
M A
MA
Harborview Injury Prevention and Research Center, Seattle, WA 98104, USA. mschiff@u.washington.edu
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000453:epidemiology / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014861:Washington / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult